4.17.11 | Merrill Goozner

New Medicare healthcare reform: Everyone for themselves

There is a dangerous but beguiling econometric logic behind the idea that turning Medicare over to the insurance industry will lower health care costs. It’s an idea that could catch on if the general public became convinced that there is nothing we can do acting together as a society to lower the cost of care. Only the market can do it, the Republicans claim. Force seniors (or the poor or anyone, for that matter) to have more skin in the game, and they’ll use their clout as consumers to separate the wheat from chaff in modern medicine. Expensive, wasteful tests, procedures, and drugs will wither for lack of customers.

Democrats, in attacking the Republican plan that passed the House, relentlessly hammered away at the cost to future seniors of having ’more skin in the game.’ Two-thirds of the cost of care within a decade of Medicare privatization in 2023 will fall on them. But the 2030s must seem very far away to people in their 40s and 50s. Isn’t it likely that they won’t think about that far-off time, but instead grab on to the promise of future lower costs, which, let’s be frank, the Affordable Care Act (health care reform) may not be able to achieve.

So here’s the real argument young and middle-aged people need to hear, and the real reason why the ’more skin in the game’ argument can never work for seniors or other vulnerable populations, including them when they reach that age. Seniors and the poor account for over half of health care spending. Within those groups, 5 percent of the population accounts for 50 percent of health care costs; and 20 percent of the population accounts for about 80 percent. These costs come for the most part at times when economic incentives have no influence at all on medical decision-making: in medical crises; in treating chronic conditions; and, for most Medicare patients, in the last six months of life.

That’s why a voucher program for Medicare, which will shift an increasing share of those inevitable costs onto the elderly themselves, can fairly be categorized as a 100 percent estate tax or death tax. People under 55 need to know that if the plan crafted by Rep. Paul Ryan were passed, most of them will never have a cent to leave to their children. It will all go to the health care industry to support the American way of dying.

The author, Merrill Goozner, is an award-winning journalist and author of “The $800 Million Pill: The Truth Behind the Cost of New Drugs” who writes regularly at Gooznews.com.

Merrill Goozner

Merrill Goozner is an award-winning journalist and author of "The $800 Million Pill: The Truth Behind the Cost of New Drugs" who writes regularly at Gooznews.com.

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Tags: health insurance, Medicare, Politics

Comments Post a comment

Because I had no faith in my doctor, I stopped seeing him over two years ago. I refuse to have any more invasive tests or take any more than the two medications that are currently prescribed to me. Yet, I still have to pay my premium out of my measly disability check. I would welcome a $15,000 voucher each year. I’m not afraid to die, like the rest of the American population.

Comment by Bet — April 18, 2011 @ 11:46 am

I am disabled by US Social Security and have Medicare Part A. I live in the Republic of Panama. If I am in a life or death health situation, where can I get help from Medicare here in this country?

Comment by Patrick J. Cain — April 18, 2011 @ 11:58 am

Something else a younger population need take note of is that the funds of seniors that will be effected will not just be what they are able to leave to their children but also what is left to them.

Comment by Sidney Anderson — April 18, 2011 @ 12:08 pm

Why is it that young congressman vote on medicare without a concern for the elderly who have paid their dues to be able to benefit from medicare. They need to create jobs to get people off medicaid instead of punishing those who have paid their taxes. Medicaid is killing us.

Comment by Joe — April 18, 2011 @ 12:21 pm

i work as a pharmacist and see elderly and midlle aged people everyday that cant afford their medication because they cant afford insurance.they have to make a decission between medicin or food.and now it is getting worse. i guess if you cant afford treatment with the 700.00 dollars a month social security that most people recieve you just lay there and wait to die. that is how much your goverment thinks about the people that pay their salary.maybe they should try to live on 700.00 dollars a month.so they can come to a better compromise.

Comment by inge nutall — April 18, 2011 @ 12:24 pm

Why not take those people who are perfectly capable of working off the free ride and make them go back to work. Some people I have heard say they have never had to work a day in their lives, yet the government is supporting them. All they do is get drunk and/or take drugs. Stop wasiting our hard earned monies on this shameful behavior. I am tired of working so they can sit at home and get a free ride at my expense.

Comment by Cindy — April 18, 2011 @ 12:39 pm

I feel for the elderly in this country who need healthcare, but I don’t think this new healthcare is at all the answer. I don’t pretend to know the answer or even have a shadow of it to offer, but I do know what the answer is NOT. It’s not more government involvement in healthcare and higher taxes (which will likely be wasted).

I ask the politicians, who suppose they qualify to mete out physician treatment choices and diagnostics through law and money, why they themselves are not beholden to the mandates put forth in this new law. Why do they have posh private care available to them (on our dollar)? Luckily, my mother has my physician family to provide immediately for her healthcare needs because if they did not, she would not be faring as well as she is.

The elderly of the future will not have a bright tomorrow if no one stands up and takes a risk with some authoritative and different ideas for them.

Comment by samantha Gluck — April 22, 2011 @ 11:11 pm